Transplantation · 2009 · 58 citations · 18 references
Life SciencesImmunologyNephrologyKidney TransplantationMonoclonal AntibodiesTransplant ImmunologyAcute RejectionAllograft RejectionGraft RejectionImmunosuppression In Kidney TransplantationImmunosuppression ManagementTransplant RejectionAcute Renal Allograft RejectionAlemtuzumab UseAllograft Survival AssessmentLymphocyte-depleting AgentsMonoclonal Antibodies In TransplantationRenal Transplant RejectionTransplantationTreatment Of Rejection Episodes
BACKGROUND: Alemtuzumab (MabCampath, Campath-1H) is a lymphocyte-depleting monoclonal antibody increasingly used in renal transplantation. This article reports the long-term follow-up data from the first series of patients treated with alemtuzumab for biopsy-proven acute rejection (BPAR). METHODS: Fifteen patients were identified who had received alemtuzumab for BPAR between November 1991 and June 1994. Patient and allograft survival were compared with a control group consisting of 25 patients with BPAR from the same era treated with intravenous methyl prednisolone, and with a contemporaneous UK renal transplant cohort. RESULTS: All rejection episodes responded to treatment with alemtuzumab but there was an excess of early infection-associated death in this group. Long-term transplant survival was similar in both groups as was allograft function (mean creatinine concentration at 10 years was 143 micromol/L in alemtuzumab cohort and 183 micromol/L in control cohort, P=0.06). There was no excess incidence of malignancy or cytomegalovirus infection in this prolonged follow-up period.
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